(289) Training CF care team members to deliver a behavioral telehealth intervention to improve adherence in adolescents and young adults with CF

Background: CF care is burdensome and those living with CF experience unique barriers. Interventions to improve adherence should be individualized and delivered using a collaborative approach. Tele-coaching, which provides education and behavioral skills training to target adherence difficulties via telehealth, may offer an effective approach to support adolescents and young adults (AYAs) with daily CF care. Recruiting CF care team members from various disciplines to serve as coaches may be an optimal strategy for designing a feasible intervention to engage AYAs in addressing barriers to daily care. The objective of this presentation is to share descriptive and feasibility data on the training and supervision of coaches involved in delivering a novel, virtual adherence intervention, as part of a feasibility pilot study.

Methods: A coach training and supervision model was implemented to prepare CF care providers to deliver an 11-session intervention incorporating education and behavioral skills to target participant-identified adherence barriers. Coach training included didactic instruction on study background and intervention modules, observation and discussion of recorded vignettes, and experiential learning. Group coach supervision was held once monthly, and individual supervision sessions were offered as needed. Demographic and participation data were collected to understand the feasibility of training team members to serve as coaches. Post-training knowledge related to intervention content was assessed to understand coach preparedness prior to intervention delivery.

Results: Fifteen clinicians (93% female) from 5 CF Centers (46% Adult, 33% Pediatric, 20% Both) agreed to participate as coaches. Four withdrew due to leaving their institution (75%) or not having time to serve in this role (25%). Eleven clinicians (73%) remain enrolled, completed training, delivered tele-coaching sessions, and participated in supervision. Disciplines include: Social Worker (n=3), Registered Nurse (n=3), Psychologist (n=3), Respiratory Therapist (n=2), Dietician (n=2), Pharmacist (n=1) and Nurse Coordinator (n=1). Most coaches had 3-5 years of experience working on a CF team (53%). Three cohorts of coaches each completed 15 hours of training. Eighty-seven percent of coaches received a passing score on the post-training knowledge assessment on the first attempt. The mean score on the assessment across coaches was 92%, suggesting they were well-prepared to deliver the intervention. A total of 20 supervision sessions have occurred to date (70% group sessions) covering 91 tele-coaching sessions across coaches. Ratings of engagement by supervisors indicated that coaches were “very engaged” in supervision (82%) vs. “somewhat engaged” (18%).

Conclusions: Tele-coaching is a proposed model of providing support to promote adherence in AYAs with CF. Given this novel model, it is important to understand the experience of CF care team members across disciplines to assess the feasibility of this approach. While this pilot study is on-going, results suggest that coaches were adequately trained to deliver this intervention, and remained enrolled in the study, an important marker of feasibility and potential outcomes of the study.

Acknowledgements: Grant supported by the CFF Therapeutics/Success with Therapies Research Consortium

References: